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SHIBA (State Health Insur. Benefits Advisors)

About SHIBA

SHIBA HelpLine is a program of the Office of the Insurance Commissioner. It provides free, unbiased information about health care coverage and access to help improve the lives of all Washington state residents. We cultivate community commitment through partnership, service and volunteering.  SHIBA in Pierce County is sponsored by South Sound Outreach Services.

Medicare Resources
Special Help for Low-Income Medicare Beneficiaries
Medicare Savings Programs and Medicare's ''Extra Help'' program provide special financial assistance for low income Medicare beneficiaries.  Visit Social Security for more information on ways to save on Part A, Part B and Part D premiums.  
Find out more about these opportunities:

Medicare Part D Annual Check Up
Annual Open Enrollment for Part D - October 15 through December 7
The Annual Open Enrollment period begins October 15 and ends December 7. CMS adds Plan Data & Ratings to the Medicare Plan Finder each year in early October.

Contact Us
The SHIBA HelpLine is ready to help you with your insurance needs. Contact SHIBA today.

  • Local phone number - (253) 596-0918
  • Statewide phone number - (800) 562-6900

Call and leave a voice mail. A SHIBA volunteer will return your call at a time convenient to you.

Prescription Drugs
Medicare's Prescription Drug Program (Part D) helps older and disabled people cover the cost of prescription drugs. To be eligible for Part D, you must have or be eligible for Medicare Hospital Insurance (Part A) or Medicare Medical Insurance (Part B), or both.

All Medicare clients are eligible for Part D, but enrollment is voluntary. If you already have prescription drug coverage, it may be as good as Part D. You should research your options before you take any action. Please note that if you qualify for extra help with Medicare's prescription drug coverage costs, you can apply for prescription drug coverage at any time.

Washington Prescription Drug Program
The Washington Prescription Drug Program (WPDP) is a new prescription drug discount program. It is open to all Washington State residents who do not have prescription drug insurance coverage, or whose insurance does not cover all their prescription drug needs. There are no other eligibility requirements or fees required for membership in the WPDP.

WPDP is a service of the Washington State Health Care Authority. Although it is not an insurance program, WPDP members can receive discount prices on drugs that are very similar to what the large health insurance companies must actually pay. On average you'll save up to 60 percent on generic drugs and 20 percent on brand-name drugs.

Call the SHIBA HelpLine for more information at (253) 596-0918 or (800) 562-6900.

Medicare
Part A: Hospital Insurance
Part A helps pay for inpatient care in qualifying, participating hospitals. It also helps pay for hospice care and some home health care. For most people, eligibility for Part A begins when they turn age 65. People with an illness such as End Stage Renal Disease or a disability may qualify before age 65.

Part B: Medical Insurance
Part B helps pay for participating doctors' services and outpatient care. It also helps cover medically-necessary services and supplies that Part A does not cover. For example, Part B covers physical therapy and durable medical equipment. Part B is open to all people who are entitled to Part A benefits, even if they chose not to enroll in Part A.

Part C: Medicare Advantage Plans
Medicare Advantage plans are a different way to get Medicare Parts A and B. Under these plans, people get Parts A and B through a private health insurance company. In addition to offering comparable coverage to Parts A and B, Medicare Advantage plans may also offer Part D coverage. There are four common types of Medicare Advantage plans:
  • Managed Care / Health Maintenance Organizations (HMO)
  • Preferred Provider Organizations (PPO)
  • Private Fee for Service (PFFS)
  • Medicare Medical Savings Account (MSA)

Part D: Prescription Drug Plans
Anyone enrolled in Parts A or B or both is eligible to enroll in Part D. To get this coverage, you enroll in a stand-alone Prescription Drug Plan (PDP) or Medicare Advantage plan with prescription drug coverage (MA-PD). These plans are approved and regulated by the Medicare program, but are actually designed and administered by private health insurance companies.

Call the SHIBA HelpLine for more information at (253) 596-0918 or (800) 562-6900.

Medicare Supplements
Medicare Parts A and B pay for many health care services and supplies, but these plans do not pay all of your health care costs. There are costs that you must pay, like co-insurance, co-payments, and deductibles. Medicare Supplement plans, commonly called Medigap plans, are private health insurance policies that provide you with a way to pay for the gaps in coverage left by Medicare Parts A and B.

What your Medigap plan covers depends on which plan you buy. There are 12 standardized Medigap plans (A through L). Plan 'A' is the most basic policy. The other plans ('B' though 'L') offer Plan 'A' benefits plus a variety of other benefits, such as coverage for medical emergencies in foreign countries and preventive health care.

Call the SHIBA HelpLine for more information at (253) 596-0918 or (800) 562-6900.

Medicaid
Medicaid is the U.S. health insurance program for individuals and families with low incomes and resources. It is jointly funded by the state and federal governments. In Washington state it is managed by the Department of Social and Health Services (DSHS).

Medicaid serves low-income parents, children, seniors, pregnant women, the blind and people with disabilities. Medicaid is the largest source of funding for medical and health-related services for people with limited income.

Note
Although their names are similar, Medicaid and Medicare are very different programs. Medicare is an entitlement program funded entirely at the federal level. It focuses primarily on the older population and individuals with long-term disabilities.

Call the Aging & Disability Resource Center for more information about Medicaid at (253) 798-4600 or (800) 562-0332.

Long-Term Care Insurance
Long-term care insurance is very complicated. It can cover medical and/or non-medical support services used during a prolonged illness, disability or loss of mental capacity.

This care may include assistance with activities of daily living such as bathing, dressing, eating, toileting, transferring or continence. It may also include grocery shopping, laundry, meal preparation, managing medications, transportation or various types of medical therapies.

Long-term care insurance may be right for you... or it may not. It's not right for everybody. Many factors will determine what is best. The right answer will require an honest and lengthy look at many issues - your current financial situation, your family needs, your long-term financial goals, and your health history, just to name a few.

Note
SHIBA HelpLine does not offer assistance with long-term care insurance issues.